Is It Strep Or Just A Bad Sore Throat? Here's How To Tell

Remember when you were younger, and the minute you had a sore throat, you’d have to go to the doctor to get a strep culture—a.k.a. have a not-so-patient doctor ask you to open your mouth as wide as you can and then, seemingly without warning, swab the back of your throat with a supersized Q-Tip. The test was always unpleasant (that was your first introduction to having a sensitive gag reflex, right?), and most of the time it came back negative.

As an adult, you're mom's probably not around to drag you to the doctor's at the first signs of a sniffle, though. So how can you tell if you have strep—and need to hit up the M.D.—and not just a bad sore throat? Here’s what Erick Eiting, M.D., medical director at the department of emergency medicine at Mount Sinai Downtown in New York City, says people should understand even before going in for that dreaded strep test.

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Christine Frapech

Strep throat is a bacterial infection that causes inflammation in the pharynx (that’s the very back part of your throat that the doctor swabs with the aforementioned giant Q-Tip). “We already have this [strep] bacteria inside our mouths and nose and on our skin,” Eiting says. “But for whatever reason, it’s able to make its way to the throat and cause an infection, which is where those painful symptoms come from.”

The most common symptom of strep throat is a sore throat that typically develops within five days of being exposed to the bacteria. “Your throat will feel swollen and sore, and it will be painful to swallow,” Eiting says. “It may even make you drool a little bit.”

But more serious symptoms include a sudden fever of 101 degrees or higher, muscle aches, a red throat with white patches, a headache, chills, swollen lymph nodes, and a loss of appetite, says Eiting.

However, a viral infection (a.k.a. a normal sore throat) can present itself similarly, according to the Cleveland Clinic, which is why it's so important to get tested as it will help determine treatment—bacterial infections get antibiotics while viral infections are just treated with rest and time.

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Christine Frapech

Resist the urge to “just assume” your sore throat will run its course. “If you have a viral infection, you do just have to let it run its course,” says Eiting. “But if it’s a bacterial infection [like strep], the earlier you come see us, the sooner we can get you antibiotics, and the sooner you’ll start feeling better.” Five minutes after that annoying throat swab, you’ll have your results. “If it’s a positive result, we’ll usually prescribe some form of penicillin,” says Eiting.

“When we look at the pharynx, we can usually see if it’s red or swollen, or if it has white spots on it, all of which suggest strep,” says Eiting. “But those also occur in viral pharyngitis, and it’s important to get a diagnosis so we can treat you properly.”

Eiting suggests isolating yourself for 24 hours after you start antibiotics to avoiding spreading strep to your loved ones or office mates. “It’s spread through bacteria, so coughing, being close to somebody, anything airborne—that’ll do it,” says Eiting. And in addition to taking your antibiotics, consider home remedies like drinking warm liquids to soothe the throat, cold liquids to help numb it, gargling salt water, or popping a throat lozenge.

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